Background

The aim of this study was to examine the accumulation of chronic physical diseases in Older-Age Bipolar Disorder (OABD) as well as in individuals from the general aging population over a 3-year period.

Methods

This prospective longitudinal study compared 101 patients with OABD receiving outpatient care (DOBi cohort) with 2545 individuals from the general aging population (LASA cohort). The presence of eight major chronic diseases was asked at baseline and 3-year follow-up. Total number of diseases was the main outcome measure. Self-rated health (SRH, scale 1-5) was examined as a secondary outcome. Multilevel linear modelling of change was performed to estimate and test the observed change in both samples.

Results

At baseline, the number of chronic diseases was lower (b= -0.47, p<0.01) and self-rated health comparable (b=0.27, p=0.13) in DOBi than in LASA. Over 3 years the number of chronic diseases increased faster in DOBi than in LASA (b=0.51 versus b=0.35, p(interaction)=0.03). When corrected for employment, depressive symptoms, waist circumference, smoking, and alcohol use, this difference was no longer significant. SRH decreased faster in DOBi than in LASA (b=-0.24 versus b=-0.02, p(interaction)=0.04).

Limitations

Information on chronic diseases was collected using self-report.

Conclusions

A faster accumulation of chronic physical diseases and a faster decline in health perception was observed in OABD than in participants from the general population. The observed differences could partly be attributed to baseline differences in psychosocial, lifestyle, and health behaviour factors. Our findings urgently call for the use of integrated care in BD.

中文翻译：

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与一般人群相比，老年双相情感障碍（OABD）的身体合并症-一项为期3年的纵向前瞻性队列研究

背景

这项研究的目的是要检查慢性双相情感障碍（OABD）以及三年来普通老龄人群中慢性病的累积情况。

方法

这项前瞻性纵向研究比较了101名接受门诊治疗的OABD患者（DOBi队列）和普通老龄人口（LASA队列）中的2545名患者。在基线和3年随访中询问了8种主要慢性病的存在。疾病总数是主要的结局指标。自我评估的健康状况（SRH，1-5级）被视为次要结果。进行了变化的多级线性建模，以估计和测试两个样本中观察到的变化。

结果

在基线时，DOBi的慢性病数量比LASA低（b = -0.47，p <0.01），自我评估的健康状况可比（b = 0.27，p = 0.13）。在3年多的时间里，DOBi中慢性病的数量增加快于LASA（b = 0.51 vs b = 0.35，p（交互作用）= 0.03）。当校正就业，抑郁症状，腰围，吸烟和饮酒后，这种差异不再显着。DOBi中的SRH下降快于LASA（b = -0.24对b = -0.02，p（相互作用）= 0.04）。

局限性

使用自我报告收集有关慢性病的信息。

结论

与普通人群相比，OABD观察到慢性身体疾病的积累更快，健康知觉的下降也更快。观察到的差异可能部分归因于心理社会，生活方式和健康行为因素的基线差异。我们的发现迫切要求在BD中使用综合护理。